Damien Divincenzo
Individual provider Active NPI Social Worker · Cortland, OH
NPI 1174334064 · NPPES record last updated Jan 18, 2025
Key facts
- NPI
- 1174334064
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Social Worker 104100000X
- License
- S.2410560
- Practice address
- 120 Windsor Dr
Cortland, OH 44410-2701 - Phone
- (330) 756-7695
- NPI assigned
- Jan 18, 2025
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Embrace Connection Counseling, LLC | Social Worker | Current |
Accepting new patients |
Locations
120 Windsor Dr
Cortland, OH 44410
Phone (330) 637-2076
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | S.2410560 | Yes |
Addresses
Primary practice location
120 Windsor Dr
Cortland, OH 44410-2701
Mailing address
732 Orlo LN
Youngstown, OH 44512-1728
Phone (330) 240-1879
Other providers in Cortland, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 18, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.